‘NO ZONE’ APPROACH IN THE MANAGEMENT OF PENETRATING NECK INJURIES – A PHILIPPINE TERTIARY HOSPITAL EXPERIENCE (RIZAL MEDICAL CENTER) alyssajanelleft@gmail.com

 

‘NO ZONE’ APPROACH IN THE MANAGEMENT OF PENETRATING NECK INJURIES – A PHILIPPINE TERTIARY HOSPITAL EXPERIENCE (RIZAL MEDICAL CENTER)

3

Philippines

Oral or Poster

The management of penetrating neck injuries has traditionally relied on an anatomical zone-based approach to determine the need for surgical exploration. However, the ‘No Zone Approach’ focuses on the patient’s clinical presentation, emphasizing hemodynamic stability and selective imaging rather than rigid zone classification. This study aims to assess the effectiveness of the 'No Zone Approach' in managing penetrating neck injuries at a Philippine tertiary hospital, Rizal Medical Center over a period of 1 year from 2023-2024.

A case series of 8 patients with penetrating neck injuries admitted under general surgery in Rizal Medical Center, Philippines were reviewed retrospectively, with patients ranging from 17 to 55 years old. The majority of injuries resulted from stab wounds, followed by gunshot wounds. The use of computed tomography angiography (CTA) was determined based on clinical need, and key surgical interventions included neck exploration, vascular repairs, mandibulomaxillary fixation, esophagoscopy, and bronchoscopy. Three patients underwent primary repair, and neck exploration was avoided in these cases by implementing the no zone approach.

The study found that selective management of penetrating neck injuries led to a reduction in unnecessary surgical explorations while ensuring prompt treatment of life-threatening injuries. A thorough clinical examination and physician discretion for individual cases is needed.

Our data parallels with findings from other regions, highlighting that the ‘no zone’ approach provides a practical and effective framework for managing penetrating neck injuries, particularly in resourcelimited settings, by prioritizing clinical signs over anatomical zones.